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Montana rates for HCPCS Q5111

Injection, pegfilgrastim-cbqv (Udenyca), biosimilar, 0.5 mg

Facilitymedian $178 · 10th–90th $145–$6760%20%10th90th$178Professionalmedian $162 · 10th–90th $162–$1,9950%50%90th$162$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,488.17 / $15,488.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $1,995.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $912.01 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $186.21
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $158.49 / $416.87
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $158.49 / $416.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $186.21 / $446.68
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $162.18 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $169.82